Opioid Use in Patients with Congestive Heart Failure. Issue 3 (27th April 2017)

• Record Type: Journal Article
• Authors: Dawson, Nancy L; Roth, Victoria; Hodge, David O; Vargas, Emily R; Burton, M Caroline
• Is Part Of: Pain medicine. Volume 19:Issue 3(2018)
• Page Start: 485
• Page End: 490
• Publication Date: 2017-04-27
• Subjects: Length of Stay -- Mortality -- Opioid -- Readmission; Pain -- Periodicals; Pain -- Treatment -- Periodicals; Analgesics -- Periodicals; Pain -- Periodicals; Pain Management -- Periodicals; Douleur -- Périodiques; Douleur -- Traitement -- Périodiques; Analgésiques -- Périodiques; Analgésique; Soulagement de la douleur; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.047205
• DOI: 10.1093/pm/pnx103
• Languages: English
• ISSNs: 1526-2375

Abstract

Abstract: Objective: To understand the relationship between opioid use in patients with congestive heart failure and outcomes, we compared length of stay (LOS), 30-day readmission rates, and 30- and 90-day mortality in patients discharged with a primary diagnosis of congestive heart failure (CHF) who were taking opioids. Design: Retrospective study design. Setting: Patients were seen at a 320-bed academic hospital. Subjects: All patients not awaiting transplant who were discharged with a primary diagnosis of heart failure from January 1, 2011, through December 31, 2014. Methods: Records were reviewed for demographic data, comorbidities, and opioid status at admission or discharge. The association of opioid use (at admission and discharge) with LOS, 30-day readmission, and 30- and 90-day mortality was examined. Results: Six hundred eighty-two patients with a principle diagnosis of heart failure were admitted during the study period, with 168 (24.6%) taking opioids at admission. Opioid use at admission was not significantly associated with 30-day readmission (odds ratio [OR] = 1.24, 95% confidence interval [CI] = 0.80–1.93), 30-day mortality (hazard ratio [HR] = 0.91, 95% CI = 0.47–1.78), 90-day mortality (HR = 0.95, 95% CI = 0.58–1.54), or LOS (parameter estimate = −0.21, 95% CI = −0.91 to 0.48). One hundred ninety-three patients (28.3%) were prescribed opioids at discharge. No significant differences were observed between those who were and were not taking opioids at discharge for 30-day readmission (OR = 1.10, 95% CI = 0.72–1.69) or for 30- or 90-day mortality (HR = 0.51, 95% CI = 0.24–1.06, and HR = 0.67, 95% CI = 0.41–1.10, respectively). LOS was slightly shorter for patients not using opioids at discharge than for those who were (mean = 3.8 vs 4.6 days, respectively). Conclusions: Opioid use at admission or discharge in patients with CHF did not appear to affect outcomes.